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Capa Cirurgia

Surgery

Precision

and Care

With the use of innovative techniques, maxillofacial surgery aims to achieve harmony between the face and teeth, ensuring correct occlusion and noticeable improvement in breathing.

With a multidisciplinary team and prioritizing a holistic approach to the patient, PCMFG Clinic has a maxillofacial surgery department focused primarily on the diagnosis and surgical treatment of facial bone development disorders.

More than representing each person’s individuality, the face is a complex structure that may present asymmetries and dentofacial deformities.

It is precisely to correct these aspects that maxillofacial surgery is used, with the goal of achieving harmony between the face and teeth while also ensuring correct occlusion and noticeable improvement in breathing.

But what are
dentofacial deformities?

In practice, these are alterations in the bones of the maxilla (upper jaw) and mandible (lower jaw), creating functional and aesthetic dysfunctions that are more common than one might think.

The main complaint from patients with these deformities is difficulty chewing because the teeth do not fit together properly (malocclusion). Some also notice a change in the size of the chin, which can negatively affect their self-esteem.

To correct these problems, the surgeon may alter the position of the jaws, which will slightly modify the positioning of other adjacent facial elements, such as the chin, lips, cheeks, and edges of the nose.

What is the relationship between maxillofacial surgery and orthodontics?

In fact, these two branches of dental medicine are closely connected and complementary.

For example, a patient requiring intervention from both a maxillofacial surgeon and an orthodontist would begin treatment with the extraction of wisdom teeth if present, followed by orthodontic alignment with Angel Aligner®, which typically lasts six months. Once this stage is complete, conditions are met to proceed with surgical intervention, followed by intensive rehabilitation.

The correction of dento-maxillofacial deformities is, therefore, considered a team effort, where the orthodontist and surgeon define a personalized plan, aiming to harmonize the patient’s maxillofacial profile for optimal aesthetic and functional results.

Questions & Answers

Which cases are indicated for surgery?

Indications for maxillofacial surgery include patients with mandibular prognathism, commonly known as a 'large chin,' retrognathism or 'small chin,' gummy smile, commonly referred to as 'gums showing,' open bite, where 'teeth do not touch at the front or back,' and cases of crossbite and facial asymmetry identified by a 'crooked or shifted face.'

What are the most common facial alterations and malocclusions?

Malocclusion occurs when there is a discrepancy between the position of the maxillary and mandibular bones, and it can be of two types: Class II and Class III. A Class II malocclusion occurs when the maxilla is advanced relative to the mandible, known as mandibular retrognathism and/or maxillary prognathism. Class III is also known as mandibular prognathism and/or maxillary retrognathism and occurs when the mandible is advanced relative to the maxilla. In other cases, malocclusion may also be associated with a narrow palate (known as the roof of the mouth), open bite, crossbite, edge-to-edge bite, overbite, or crowded teeth. Besides malocclusions, incorrect placement of the mandibular bones can cause other malformations, such as facial asymmetry (when one side or part of the face is unbalanced with the other) and a gummy smile (excess gum tissue visible when smiling).

Who can help me resolve these problems?

The initial evaluation should be done by an orthodontist or maxillofacial surgeon. The treatment plan will then be outlined by a multidisciplinary team, which will analyze the patient's complaints, occlusion, jaw size, and facial harmony to design the treatment.

Why should I treat malocclusion?

When teeth do not fit together correctly, the patient may feel that the tissues surrounding the tooth are injured during movements such as chewing. This injury can cause inflammation, and consequently, the bone will begin to lose thickness. Additionally, malocclusion can cause temporomandibular joint injuries, as well as negatively impacting aesthetics.

When can I start orthodontic treatment?

There is no age limitation to start orthodontic treatment, but it is advisable for the first consultation to be between 6/7 years old. It is at this stage that the problem should be corrected with functional orthodontic appliances.

When can I undergo surgical treatment?

Maxillofacial surgery is indicated for people over 18 years old.

What does the first maxillofacial surgery consultation consist of?

The surgeon will evaluate the case using elements such as complaints, dental occlusion problems, or other associated pathologies and diagnostic tests such as orthopantomography, lateral skull X-ray, plaster dental models, intra- and extra-oral photos, and profile photos. After analyzing all the elements, a treatment plan is presented, and the risks are discussed.

What happens during pre-surgical orthodontic treatment?

This pre-surgical treatment aims to provide the surgeon with a stable and adequate structure between the upper and lower arches, aligning the teeth according to the desired skeletal movements. It is recommended to use Angel Aligner® since it is possible to achieve faster results (between 6 and 12 months). After this initial treatment is completed, new dental records are made, and planning is done with the support of 3D digital programming methods.

What are the dietary and hygiene guidelines after surgery?

For three days after surgery, liquids such as yogurt, ice cream, and baby food should be the base of the diet. Then, the surgeon will give instructions for the progressive reintroduction of solid foods, but it is important to ensure that for 12 days after the procedure, no granular foods are ingested, no mouth rinsing or nose blowing is done. During this phase, oral hygiene is also crucial, which should be done with a soft-bristle brush several times a day, along with mouthwash and the application of antiseptic oral gel.

Do I have to use elastics on my teeth after surgery?

Yes, and proper use of elastics is crucial to achieving successful results. These should be maintained during the first few days post-surgery, even during meals. Gradually, the time of use and the strength of elasticity will be reduced.

What types of maxillofacial surgery are there?

Maxillary Surgery – Aims to correctly position the upper jaw, a fundamental bone in breathing, chewing, and speech.Mandibular Surgery – The most common in this segment is mandibular advancement surgery, indicated for patients with a small jaw that is retracted relative to the maxilla.Maxillomandibular or Bimaxillary Surgery – This type of surgery consists of repositioning the maxilla and mandible to achieve correct occlusion and facial harmony.Mentoplasty – It is an outpatient chin surgery but can also be performed during bimaxillary surgery to achieve ideal harmony. Through it, it is possible to enlarge, reduce, or symmetrize the face.

Can sleep apnea be resolved with maxillofacial surgery?

Indications for maxillofacial surgery include patients with mandibular prognathism, commonly known as a 'large chin,' retrognathism or 'small chin,' gummy smile, commonly referred to as 'gums showing,' open bite, where 'teeth do not touch at the front or back,' and cases of crossbite and facial asymmetry identified by a 'crooked or shifted face.'